BREAKING BARRIERS: COGNITIVE INSIGHTS FROM DEAF AND HARD OF HEARING STUDENTS

Eu opean Summi on In e disciplina y Resea ch and De elopmen - An In e na ional Resea ch Con e ence
Published By C ys al Pen Publica ion, Pe ambalu , Tamil Nadu, India - www.c ys alpen.in
ESIRD - 2025 P oceedings, Da e: No embe 30, 2025, ISBN Numbe : 978-93-49435-80-3
61
BREAKING BARRIERS: COGNITIVE INSIGHTS FROM DEAF
AND HARD OF HEARING STUDENTS
Madhusudhan U*, Vidya Singa a elu**, Kalapana M*** &
Ni in Ashok John****
* Associa e P o esso , Depa men o Physiology, AIIMS, Bibinaga , Yadada i
Bhu anagi i, Telangana, India
** P o esso Paedia ics, Malla Reddy Vishwa idyapee h (Deemed o be Uni e si y),
Su a am, Hyde abad, Telangana, India
*** Addi ional P o esso , Depa men o Physiology, AIIMS, Bibinaga , Yadada i Bhu anagi i, Telangana, India
**** P o esso & Head, Depa men o Physiology, AIIMS, Bibinaga , Yadada i Bhu anagi i, Telangana, India
Ci e This A icle: Madhusudhan U, Vidya Singa a elu, Kalapana M, Ni in Ashok John. (No embe 2025).
B eaking Ba ie s: Cogni i e Insigh s om Dea and Ha d o Hea ing S uden s. In P oceedings o he Eu opean
Summi on In e disciplina y Resea ch and De elopmen (pp. 61-64). Pe ambalu , Tamil Nadu, India: C ys al
Pen Publica ion.
ISBN: 978-93-49435-80-3
Publishe Websi e: www.c ys alpen.in
Copy Righ : © 2025 C ys al Pen Publica ion (CPP). All igh s ese ed. This is an open access a icle
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DOI:
Abs ac :
Hea ing and language play a i al ole in child en’s cogni i e, social, and emo ional g ow h. Howe e ,
child en who a e dea o ha d o hea ing (DHH) o en encoun e ba ie s o cogni i e and linguis ic de elopmen
despi e ha ing no mal in elligence. This c oss-sec ional compa a i e s udy aimed o assess he cogni i e
abili ies o DHH school child en and compa e hem wi h hei no mal-hea ing pee s using Bha ia’s Ba e y o
Pe o mance Tes s. A o al o 60 s uden s (30 DHH and 30 no mal-hea ing), s udying in g ades 5 o 8,
pa icipa ed be ween 2022 and 2023. Da a we e analyzed using IBM SPSS e sion 21, wi h p < 0.05 conside ed
s a is ically signi ican .
Resul s e ealed ha DHH child en demons a ed signi ican ly highe mean sco es in mos sub es s,
including Koh’s Block Design, Alexande ’s Pass-Along, and Pa e n D awing Tes s (p < 0.05). The In elligence
Quo ien (IQ) and Pe o mance Quo ien (PQ) we e also signi ican ly highe in he DHH g oup (IQ: 98.53 ±
6.73; PQ: 107.23 ± 7.57) compa ed o con ols. These indings sugges enhanced isual-spa ial cogni i e skills
among DHH child en, possibly due o compensa o y neu al adap a ions and ex ensi e use o sign-based
communica ion.
The s udy highligh s ha dea and ha d o hea ing child en possess cogni i e abili ies compa able o, o
e en exceeding, hose o hea ing pee s in speci ic domains. P omo ing awa eness o hese s eng hs can help
dispel social s igma, encou age inclusi e educa ional p ac ices, and empowe DHH s uden s o each hei ull
in ellec ual po en ial.
Key Wo ds: Dea and Ha d o Hea ing, Cogni i e Func ion, Bha ia’s Ba e y, In elligence Quo ien ,
Pe o mance Quo ien , Visual Cogni ion, Neu al Plas ici y.
In oduc ion:
Hea ing and language a e essen ial o a child’s cogni i e, social, and emo ional de elopmen , allowing
hem o unde s and and in e ac wi h hei en i onmen . In child en wi h hea ing loss, he p ima y challenge lies
in de eloping e ec i e communica ion skills. Despi e ha ing no mal in elligence, many dea child en ace
ba ie s o cogni i e and linguis ic de elopmen due o limi ed language exposu e. 1,2 Ea ly iden i ica ion o
hea ing impai men h ough newbo n sc eening p og ams can g ea ly enhance speech and language
de elopmen , imp o e academic pe o mance, and open up b oade p o essional oppo uni ies la e in li e.
Globally, app oxima ely 466 million people (abou 5% o he wo ld’s popula ion) li e wi h disabling
hea ing loss, including 34 million child en. 3 In India, nea ly 63 million indi iduals (6.3%) expe ience
signi ican audi o y impai men . I is es ima ed ha ou in e e y 1,000 child en a e a ec ed by se e e o
p o ound hea ing loss, and o e 100,000 in an s a e bo n wi h hea ing de iciencies each yea . The p e alence o
adul -onse dea ness in India is a ound 7.6%, while childhood-onse dea ness accoun s o 2%. Social s igma
su ounding disabili y o en leads o unde epo ing o cases by amilies.4-5
P e ious esea ch e alua ing cogni i e abili ies such as a en ion, memo y, c i ical hinking, and
p oblem-sol ing in dea child en has p oduced inconsis en indings. Some s udies ha e epo ed ha he
in elligence quo ien (IQ) o dea indi iduals is compa able o ha o hei hea ing coun e pa s,6-8 whe eas
o he s ha e ound lowe IQ sco es among he dea popula ion. 9,10-11 Howe e , he e is a no able sca ci y o
Indian s udies explo ing his a ea. The e o e, he p esen s udy was designed o assess cogni i e skills in dea
and ha d o hea ing (DHH) school child en using Bha ia’s Ba e y o Pe o mance Tes s.
Eu opean Summi on In e disciplina y Resea ch and De elopmen - An In e na ional Resea ch Con e ence
Published By C ys al Pen Publica ion, Pe ambalu , Tamil Nadu, India - www.c ys alpen.in
ESIRD - 2025 P oceedings, Da e: No embe 30, 2025, ISBN Numbe : 978-93-49435-80-3
62
Me hodology:
This s udy was a c oss-sec ional compa a i e s udy conduc ed be ween 2022 and 2023. The esea ch
included dea and ha d o hea ing (DHH) school child en om 5 h o 8 h g ade. The s udy p o ocol was
e iewed and app o ed by he Ins i u ional E hics Commi ee (IEC). Assen was ob ained om all pa icipa ing
child en, and w i en consen was secu ed om he school p incipal p io o pa icipa ion.
Fo he con ol g oup, no mal-hea ing child en wi hou any hea ing o speech impai men s, ma ched o g ade
le el (5 h o 8 h), we e included. Simila p ocedu es we e ollowed o ob aining assen and ins i u ional
consen .
The s udy pe iod was chosen be ween 2022 and 2023, as schools emained closed du ing 2021 due o
he COVID-19 pandemic, which had delayed da a collec ion. We included 30 dea & ha d o hea ing child en
&30 no mal child en wi hou dea ness & speech impai men .
Bha ia’s Ba e y o Pe o mance Tes :
Bha ia’s Ba e y o Pe o mance Tes is applicable o bo h li e a e and illi e a e indi iduals, wi h
speci ic adminis a ion ules ailo ed o each g oup. The es is designed o child en aged 11 o 16 yea s and can
be adminis e ed wi hin 45 o 60 minu es. The s anda diza ion o he i e sub es s was ca ied ou o e a ou -
yea pe iod in a ious u al and u ban egions ac oss India, ensu ing b oad applicabili y and cul u al ele ance.
The es has demons a ed good alidi y (0.77) and shows a co ela ion anging om 0.67 o 0.82 wi h o he
es ablished measu es o in elligence.
Da a Analysis:
Da a en y was ca ied ou using Mic oso Excel 2019, and s a is ical analysis was pe o med wi h
IBM SPSS S a is ics e sion 21. The esul s we e summa ized and displayed h ough ables and g aphical
ep esen a ions, including ba cha s, pie cha s, and equency dis ibu ions. Desc ip i e s a is ics such as mean
and s anda d de ia ion we e calcula ed. To assess di e ences be ween g oups, an independen samples - es
was applied, and a p- alue < 0.05 was conside ed o indica e s a is ical signi icance.
Resul s:
The mean age o he s udy g oup was 10.9 ± 1.12 yea s, while ha o he con ol g oup was 11.86 ±
1.22 yea s. Each g oup consis ed o 16 boys and 18 gi ls. The sco es ob ained in he a ious sub es s o Bha ia’s
Ba e y o Pe o mance Tes s a e summa ized in Table 1. The s udy g oup demons a ed signi ican ly highe
sco es han he con ol g oup, wi h s a is ical signi icance a p < 0.005. Table 2 p esen s he compa ison o
In elligence Quo ien (IQ) and Pe o mance Quo ien (PQ) be ween he wo g oups, indica ing ha bo h IQ and
PQ alues we e signi ican ly highe among he s udy pa icipan s compa ed o con ols.
Table 1: Compa ison o Sco es o Va ious Tes s be ween Two G oups
Name o he Tes
Sco es
T Value
P Value
S udy G oup
Con ol G oup
Koh’s Block Design Tes (25)
12.11.51
9.371.38
8.7162
0.0001*
Alexande ’s Pass-along Tes (20)
9.52.09
7.872.22
3.7802
0.0003*
Pa e n D awing Tes (20)
8.52.43
7.631.44
2.1779
0.03*
Immedia e memo y es o digi s (15)
5.931.52
5.531.23
1.4465
0.1512
Pic u e cons uc ion Tes (15)
7.21.30
6.901.14
1.2269
0.222
TOTAL (95)
43.32.89
37.34.72
7.6658
0.0001*
* S a is ically Signi ican
Table 2: Compa ison o IQ & PQ Sco es be ween Two G oups
S udy G oup
Con ol G oup
T Value
P Value
In elligence Quo ien (IQ)
98.536.73
95.69.34
3.330
0.03*
Pe o mance Quo ien (PQ)
107.237.57
103.48.91
3.830
0.01*
* S a is ically Signi ican
Discussion:
The s udy was conduc ed o assess cogni i e unc ions in dea and ha d o hea ing school going
child en using Bha ia ba e y o es s, calcula e Pe o mance quo ien & In elligence quo ien om Bha ia
ba e y o es s & compa e i wi h he age ma ched con ol popula ion wi hou speech & hea ing impai men .
The ollowing 2 poin s de i ed om he esul s
 The es sco es we e highe in dea and ha d o hea ing school child en, when compa ed wi h con ol
g oup
 The PQ & IQ sco es we e also highe in dea and ha d o hea ing school child en, when compa ed wi h
con ol g oup
Concen a ion & Focus in Dea and Ha d o Hea ing in Compa ison Wi h No mal Child en:
Concen a ion a igue is equen ly obse ed in indi iduals who a e dea o ha d o hea ing, as hey
mus cons an ly ocus on lip- eading, sign language, and o he isual cues o unde s and communica ion. This
sus ained men al e o inc eases cogni i e load, making p ocessing in o ma ion mo e demanding. E en hose
Eu opean Summi on In e disciplina y Resea ch and De elopmen - An In e na ional Resea ch Con e ence
Published By C ys al Pen Publica ion, Pe ambalu , Tamil Nadu, India - www.c ys alpen.in
ESIRD - 2025 P oceedings, Da e: No embe 30, 2025, ISBN Numbe : 978-93-49435-80-3
63
wi h mild hea ing impai men may expe ience lis ening a igue, which can be men ally exhaus ing and, a imes,
o e whelming. 12
To add ess his, we chose an assessmen ool ha minimizes he need o p olonged a en ion o e bal
ins uc ions. Bha ia’s Ba e y o Pe o mance Tes s is skill-based, whe e he examine demons a es each ask,
and pa icipan s eplica e i wi hin a se ime. This app oach allows dea and ha d o hea ing child en o
comple e he asks wi hou excessi e eliance on audi o y inpu , p o iding a mo e accu a e e alua ion o hei
cogni i e abili ies.
Acco ding o he concep o compensa o y plas ici y, he absence o audi o y inpu in dea indi iduals
is o en accompanied by enhanced isual cogni i e abili ies. When con olling o a ious con ounding ac o s,
s udies ha e shown ha dea ness can in luence he spa ial alloca ion o a en ion, shi ing ocus owa d he
pe iphe al isual ield a he han he cen al ield. This eo ganiza ion is e lec ed in neu al adap a ions ha
ex end om highe associa ion co ices o ea ly senso y co ices. A common ea u e ac oss hese eo ganized
egions is hei mul imodal o ganiza ion, suppo ing cu en heo ies ha mul imodal in eg a ion plays a c i ical
ole a all s ages o cogni i e p ocessing.13,14
Ce ain cogni i e unc ions, such as pe iphe al isual p ocessing and mo ion de ec ion, demons a e
imp o ed pe o mance in dea indi iduals, bu p ima ily when asks equi e ocused a en ion. Fo example,
Ne ille and Lawson15 ound ha dea pa icipan s ou pe o med hea ing con ols in de ec ing he di ec ion o
mo ion o pe iphe al a ge s when a en ion was di ec ed o he ele an loca ion.
Mode o Skill Acquisi ion in Dea and Ha d o Hea ing Child en in Compa ison Wi h No mal Child en:
Al hough he o e all s uc u e o he human b ain is la gely es ablished du ing ea ly childhood,
lea ning and memo y emain possible h oughou li e due o he abili y o indi idual neu ons o adap hei
signaling and synap ic connec ions.16Lea ning p ima ily occu s h ough changes in he s eng h and numbe o
synap ic connec ions be ween exis ing neu ons, a phenomenon e e ed o as synap ic plas ici y.17In mos cases,
equen ly used connec ions a e ein o ced, while less ac i e connec ions weaken, e lec ing he “use i o lose
i ” p inciple o neu al adap a ion. Resea ch has consis en ly shown ha neu onal connec ions ac oss a ious
b ain egions a e dynamic and can be modi ied.18 This synap ic plas ici y unde lies beha io al lea ning and
memo y o ma ion, wi h memo ies encoded by adjus ing speci ic synap ic connec ions, s o ed wi hin
in e connec ed neu al ensembles, and e ie ed by eac i a ing he same neu al ci cui s.
Dea and ha d o hea ing child en’s pe o mance in he asks was signi ican ly be e han hei no mal
coun e pa may be due o ollowing easons.
 Child en wi h dea ness, ega dless o hei e iology, ha e been educa ed and ained by sign language
o many yea s. We assessed cogni ion in 5 h o 8 h g ade child en
 Resea ch e idences show ha dea child en ha e enhanced isual cogni ion in compa ison wi h no mal
child en, since ou majo i y o he asks a e based on isual concen a ion/ ocus.
Conclusion:
The p esen s udy demons a es ha dea and ha d o hea ing child en possess IQ le els compa able o,
and in some cases s a is ically highe han, hei hea ing pee s. These indings may help amilies mo e beyond
he social s igma associa ed wi h hea ing impai men , highligh ing he cogni i e po en ial o hese child en.
Recognizing hei capabili ies can p o ide oppo uni ies o equi able educa ion and skill de elopmen , enabling
hem o achie e ou comes compa able o hei hea ing coun e pa s and os e ing a b igh e , mo e inclusi e
u u e.
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